The Government’s review Transforming Care: A national response to “Winterbourne View Hospital: Department of Health Final Report (2012)” looked at why Winterbourne View happened and set out a programme of work to take every step we can, to ensure this does not happen again. The Government committed in Transforming Care to produce a report two years on to account for progress. This report is a collective account from partners across the health and care system to reflect the cross-system effort that has continued over the past year to tackle the root causes of the abuse and treatment of people at Winterbourne View.
The report sets out what has been done, providing an update in the annex of all the original actions in Transforming Care and what has been completed or is continuing. A significant number of the recommendations have been achieved. We now know how many people are in in-patient settings, where they are and who is responsible for them. NHS England has introduced care and treatment reviews for everyone in in-patient settings, with a multi-disciplinary team from health and social care, alongside experts by experience. One hundred and eighty one people are benefiting from £7 million DH capital funding to support people inappropriately placed in in-patient settings to move to more suitable housing. We have strengthened the accountability and corporate responsibility arrangements to assure the quality and safety of care services. A duty of candour which requires providers to inform service users where there are failings in care came into force for NHS providers last November, and will be extended to all other providers registered with the Care Quality Commission in this April. A fit and proper person’s test which requires providers to ensure that directors are fit to carry out their role came into force last November for NHS providers in NHS trusts, foundation trusts and special health authorities. All other providers will be required to comply by this April. The introduction of the forthcoming statutory offences of ill-treatment or wilful neglect will also send a clear message throughout the health and care system that intentionally poor care will never be tolerated. We have new guidance on minimising restrictive interventions and work is underway to improve data about the use of restraint. A more rigorous registration, assessment and inspection approach is in place for learning disability services. The Care Act 2014 enshrines new principles for adult social care including the principle of individual well-being which encompasses people having control of their day to day life, suitable accommodation and being able to contribute to society. The Act requires local authorities to consider people’s views, wishes and beliefs and focuses on the outcomes people themselves want to achieve. The Act also underpins and reinforces the importance of good quality, independent advocacy and will support people, their families and carers to raise concerns.
The report is also clear, however, that we have not made nearly enough progress to transform services. This cannot be tolerated. We recognise that there is still much more to do to reduce the need for in-patient care. There are many people with very complex needs, in many different types of in-patient settings and we need to ensure the right decisions are made about their care, listening to individuals, their families and carers. All partners involved in Transforming Care have agreed the need for a single programme to collectively drive forward the changes needed. A strengthened programme will be put in place, which takes into consideration the recommendations of Winterbourne View—A Time to for Change (2014) by Sir Stephen Bubb, and will drive a better co-ordinated approach to achieve faster and sustainable progress. The details of this approach can be accessed at: http://www.england.nhs.uk/ourwork/gual- clin- lead/ld/transform-care/.
Partnership working is essential. We are clear that this cannot all be done from Whitehall. There has to be a change in culture and behaviour in local areas. We understand that this is not easy which is why, building on learning from work over the past two years, we are determined to make a difference for people and their families in the decisions about admission and discharge from hospitals. We are looking to consult on a range of potential future measures to strengthen people’s rights in the health and care system. This is likely to include options for ensuring people’s individual well-being is at the heart of decisions in both health and social care, and issues around how the Mental Health Act is applied.
Copies of the Winterbourne View Two Years On report have been placed in the House Library. It can also be accessed at: